title: Moving from street to home: health status of entrants to a housing first program.
abstract: Housing First (HF) is an evidence-based practice that ends chronic homelessness for individuals with serious mental illness by providing immediate access to permanent independent housing and team-based community supports. Little is known about the health status of homeless individuals entering HF programs. Through a cross-sectional analysis, this paper reports on the chronic physical disease burden of people entering a newly established HF program and examines whether these individuals recognize and request support for ongoing health-related issues. The authors' evaluation confirmed significantly higher rates of chronic disease (60%) and fair/poor self-reported health status (47%) than the general urban population of Philadelphia. The majority of clients reported they wanted to address both medical (67%) and mental health (68%) problems, but a much lower percentage reported wanting to reduce substance use (23%) or take psychiatric medications (25%). The authors conclude that formerly homeless entrants to HF programs have a high burden of chronic disease with complex health-related needs. Additionally, these individuals look to the program for health-related assistance. As the HF model is disseminated throughout the United States to end chronic homelessness, these findings support the development of flexible, integrated, person-centered health services within the HF service delivery system as a potentially effective method to address complex health needs.
authors.affiliation: Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Lara Carson
authors.initials: LC
authors.lastname: Weinstein
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Henwood
authors.forename: Jason
authors.initials: J
authors.lastname: Matejkowski
authors.forename: Abbie J
authors.initials: AJ
authors.lastname: Santana
keywords: chronic disease; health status; homelessness; self-reported health; serious mental illness